Association of body composition with bone mineral density and fracture in diabetic elderly: Results from AHAP study.

BACKGROUND: Diabetes is a common metabolic disorder and one of its comorbidities is osteoporosis. In previous studies, the effect of lean mass and fat mass on bone has been investigated separately. Therefore, the aim of this study was to investigate the association between body composition with bone mineral density (BMD) and fractures in diabetic elderly. METHODS: This population based cross-sectional study is part of the second phase of the Amirkola Health and Ageing Cohort Project (AHAP). Diabetes was diagnosed by fasting blood glucose level twice greater than or equal to 126 mg/dl. BMD and body composition were measured by Hologic Horizon-WI densitometer. History of fracture was obtained by asking the elderly individual. Then data were analyzed using statistical tests and ROC curve. RESULTS: Out of 469 elderly diabetics, 270 (57.57%) were women. The mean age was 68.70±6.18. Older people with osteopenia, osteoporosis and fracture had lower visceral fat mass (VFM), lean mass (LM) and waist circumference (WC) than normal people. The mean BMD in elderly with less than 10 years of diabetes history was greater and the percentage of fractures in elderly individuals with more than 10 years of diabetes was higher. In Roc analysis, the highest area under the curve was related to LM 78% (0.78±0.02), WC 67% (0.67±0.03) and VFM 62% (0.62±0.03) for estimation of osteoporosis. CONCLUSION: In this study, LM, WC and VFM had the greatest effect on BMD and fracture in elderly diabetic.